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健康状態申告書
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名前
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風邪症状はあるか？ないか？
*
ある
ない
感染地区への移動はあるか？ないか？
*
ある
ない
検温 何℃
*
37.5℃以上
37℃～37.4℃
36.5℃～36.9℃
36℃～36.4℃
35.9℃以下
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